VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH AND WELFARE BENEFITS PLAN
|
2018
|
222511614
|
2019-07-17
|
VALLEY HEALTH SERVICES, INC.
|
274
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W GERMAN ST, HERKIMER, NY, 133502135
|
Plan sponsor’s
address |
690 W GERMAN ST, HERKIMER, NY, 133502135
|
Number of participants as of the end of the plan year
Active participants |
219 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-17 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH AND WELFARE BENEFITS PLAN
|
2017
|
222511614
|
2018-09-26
|
VALLEY HEALTH SERVICES, INC.
|
207
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W GERMAN ST, HERKIMER, NY, 133502135
|
Plan sponsor’s
address |
690 W GERMAN ST, HERKIMER, NY, 133502135
|
Number of participants as of the end of the plan year
Active participants |
274 |
Retired or separated participants receiving
benefits |
5 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-09-26 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH AND WELFARE BENEFITS PLAN
|
2016
|
222511614
|
2017-07-27
|
VALLEY HEALTH SERVICES, INC.
|
246
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W GERMAN ST, HERKIMER, NY, 133502135
|
Plan sponsor’s
address |
690 W GERMAN ST, HERKIMER, NY, 133502135
|
Number of participants as of the end of the plan year
Active participants |
207 |
Retired or separated participants receiving
benefits |
5 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-07-27 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH AND WELFARE BENEFITS PLAN
|
2015
|
222511614
|
2016-07-27
|
VALLEY HEALTH SERVICES, INC.
|
228
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W GERMAN ST, HERKIMER, NY, 133502135
|
Plan sponsor’s
address |
690 W GERMAN ST, HERKIMER, NY, 133502135
|
Number of participants as of the end of the plan year
Active participants |
241 |
Retired or separated participants receiving
benefits |
5 |
Signature of
Role |
Plan administrator |
Date |
2016-07-27 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-27 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH & WELFARE BENEFITS PLAN
|
2014
|
222511614
|
2015-07-15
|
VALLEY HEALTH SERVICES, INC.
|
247
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W. GERMAN STREET, HERKIMER, NY, 13350
|
Plan sponsor’s
address |
690 W. GERMAN STREET, HERKIMER, NY, 13350
|
Number of participants as of the end of the plan year
Active participants |
222 |
Retired or separated participants receiving
benefits |
6 |
Signature of
Role |
Plan administrator |
Date |
2015-07-15 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH & WELFARE BENEFITS PLAN
|
2013
|
222511614
|
2014-07-25
|
VALLEY HEALTH SERVICES, INC.
|
237
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Plan sponsor’s
address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Plan administrator’s name and address
Administrator’s EIN |
222511614 |
Plan administrator’s name |
VALLEY HEALTH SERVICES, INC. |
Plan administrator’s
address |
690 W. GERMAN ST., HERKIMER, NY, 13350 |
Administrator’s telephone number |
3158663330 |
Number of participants as of the end of the plan year
Active participants |
238 |
Retired or separated participants receiving
benefits |
9 |
Signature of
Role |
Plan administrator |
Date |
2014-07-25 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-25 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH & WELFARE BENEFITS PLAN
|
2012
|
222511614
|
2013-07-16
|
VALLEY HEALTH SERVICES, INC.
|
239
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Plan sponsor’s
address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Number of participants as of the end of the plan year
Active participants |
231 |
Retired or separated participants receiving
benefits |
6 |
Signature of
Role |
Plan administrator |
Date |
2013-07-16 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-16 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH & WELFARE BENEFITS PLAN
|
2011
|
222511614
|
2012-07-18
|
VALLEY HEALTH SERVICES, INC.
|
229
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Plan sponsor’s
address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Plan administrator’s name and address
Administrator’s EIN |
222511614 |
Plan administrator’s name |
VALLEY HEALTH SERVICES, INC. |
Plan administrator’s
address |
690 W. GERMAN ST., HERKIMER, NY, 13350 |
Administrator’s telephone number |
3158663330 |
Number of participants as of the end of the plan year
Active participants |
232 |
Retired or separated participants receiving
benefits |
7 |
Signature of
Role |
Plan administrator |
Date |
2012-07-18 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH & WELFARE BENEFITS PLAN
|
2010
|
222511614
|
2011-07-05
|
VALLEY HEALTH SERVICES, INC.
|
240
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Plan sponsor’s
address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Plan administrator’s name and address
Administrator’s EIN |
222511614 |
Plan administrator’s name |
VALLEY HEALTH SERVICES, INC. |
Plan administrator’s
address |
690 W. GERMAN ST., HERKIMER, NY, 13350 |
Administrator’s telephone number |
3158663330 |
Number of participants as of the end of the plan year
Active participants |
224 |
Retired or separated participants receiving
benefits |
5 |
Signature of
Role |
Plan administrator |
Date |
2011-07-05 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY HEALTH SERVICES, INC. EMPLOYEE HEALTH AND WELFARE BENEFITS PLAN
|
2009
|
222511614
|
2010-10-05
|
VALLEY HEALTH SERVICES, INC.
|
204
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3158663330
|
Plan sponsor’s mailing address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Plan sponsor’s
address |
690 W. GERMAN ST., HERKIMER, NY, 13350
|
Plan administrator’s name and address
Administrator’s EIN |
222511614 |
Plan administrator’s name |
VALLEY HEALTH SERVICES, INC. |
Plan administrator’s
address |
690 W. GERMAN ST., HERKIMER, NY, 13350 |
Administrator’s telephone number |
3158663330 |
Number of participants as of the end of the plan year
Active participants |
231 |
Retired or separated participants receiving
benefits |
9 |
Signature of
Role |
Plan administrator |
Date |
2010-10-05 |
Name of individual signing |
LISA BETRUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|